My name is danah boyd and I'm a Principal Researcher at Microsoft Research and the founder/president of Data & Society. Buzzwords in my world include: privacy, context, youth culture, social media, big data. I use this blog to express random thoughts about whatever I'm thinking.

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CVS refused to fill my prescription; is this legal?

A week ago, I went to my normal pharmacy to get a prescription filled. When they told me they were out but could order it for me, I decided to try the nearby CVS. I was trying to make errand-running a one-day event. I walked into the CVS on Lincoln in Venice and politely waited my turn. When I handed my prescription to the clerk, she turned to the pharmacist to see if he had it available. He looked my prescription, looked at me, and said “I’m not filling that.” Confused, I asked him what? He repeated that he would not fill it and gave me a look that made me feel as though I was somehow a bad person. When I asked why, he grew curt and told me that he doesn’t fill prescriptions from out-of-town doctors. The woman waiting in line next to me rebuked his claim when she responded, “you always fill mine and my doctor is in Santa Barbara.” He silenced her with a stern look and told her this was none of her business. Standing amidst a flood of customers, I was too shocked and embarrassed to know what to do. So I left.

I’ve heard stories of people being refused emergency contraception, but my prescription has nothing to do with birth control. I’ve heard stories of people abusing the ADHD medication that I’m on, but I’ve been responsibly taking this particular medication since 2001 and my doctor would’ve easily confirmed that. I am a Berkeley student and my doctor is based in Berkeley. I have been seeing him since I arrived in Berkeley in 2003. When I moved to Los Angeles, he and his colleagues started sending me a physical prescription to fill down here provided that I visit annually for a check-up. Because my prescription is scheduled, it can’t simply be called in. Due to a bad reaction to whatever gelatin or sugar is used in the generic, I’ve always been given the brand name prescription. I hate paying the extra money, but I hate the headaches a whole lot more. While I’ve been given plenty of sympathetic looks when I shell out major duckets for the prescription, I’ve never been given a problem by a pharmacy before.

My shock has since turned into a series of emotions. Confusion, anger, frustration. I contacted CVS to voice my complaint and was told that “a Pharmacist works under their own private license and reserves the right to refuse to fill for any reason.” Is this true? I cannot find authoritative information on the matter and I’m quite confused, so I have some questions for anyone who knows more than I do:

Under what circumstances can a pharmacist refuse a prescription?

Are there laws that dictate when and how pharmacists can refuse a valid prescription even when it can be confirmed by the doctor and does not conflict with any other medication?

Are there examples of people being denied legitimate prescriptions for things other than contraception?

How often are people denied their prescriptions?

What recourses and alternatives do patients have when they are denied?

According to the USA Today, “The policy at most drug store chains and the American Pharmacists Association is that druggists shouldn’t be forced to violate their beliefs, but they must make arrangements so the patient can still get the pills from another pharmacist at the store or direct the patient to a store that will fill the order. That makes sense. Pharmacists with objections to some medicines should identify those situations ahead of time, and stores should let the public know their policies.” This was not the case at CVS. There were no signs saying that they wouldn’t accept my prescription nor did the pharmacist make any offer to connect me with someone else or encourage me to come back at a different time. He simply chased me away and glared at me as though I was a criminal.

Anyhow, I’m not sure what I can do other than never step foot in a CVS again. I’m lucky that I have choices, but, knowing that many people do not, the way that I was treated and refused service makes me really upset.

Update: the CVS pharmacy supervisor of Los Angeles called me to get more information. He agreed that what the pharmacist did was inappropriate and that, if he had doubts about the legitimacy of my prescription, he should have called Berkeley or held onto it to call in the morning. The supervisor said that he would make certain that his pharmacists had a proper protocol for what to do when they were confronted with similar situations. He was deeply apologetic and professional.

The supervisor also made me realize one omission in my story. I have a long history of filling this prescription at other CVSes in Cambridge and San Francisco. The supervisor told me that the pharmacist would have been able to look my name up and see that record at other stores such that, even if he had never seen me before, CVS would have recognized me and my prescription as legitimate and having history.

I don’t know what the outcome will be for the pharmacist, but my hope is that CVS will actually do something to redress the broader issue, if only to not blemish their brand. Hopefully my experience and willingness to object will lead to new policies that will protect those less fortunate from being denied prescriptions in the future.

165 comments to CVS refused to fill my prescription; is this legal?

Wow. You guys have no idea how stressful it is to try to figure out if a certain prescription is legit. I am a pharmacist myself and just in the past week, I filled two prescriptions for xanax and vicodin that was fake and I had no idea about it. Later, we found out that there was an identity theft and someone was filling these prescriptions under somebody else’s name and that person had no idea. In very unlucky situations, pharmacist could be fined, license suspended or go to jail for filling the wrong prescriptions. We always have to be very strict about controlled medications like adderall (being one of the highly controlled meds). To avoid identity theft situations, of course the pharmacist will check id to make sure this is for you. Of course, in Danah’s situation, I would have called the doctors office to verify but some fake prescriptions (that look real) have fake “doctor’s info” on the prescription and when we call to verify, this fake doctor will say “yeah its okay to fill” and who knows who’s answering the phone. having so many abusers out there, its really hard to verify if a certain prescription is truly real or not unless we have experience filling controlled prescriptions from the same doctor over and over again and we trust the office or we know you well enough to trust that you are using it for legit purposes. thats why pharmacists usually want to fill from local doctors offices that we trust. dont blame the pharmacist for being strict. blame the abusers who made it hard for people who take it for real medical needs to get the meds. thats why the laws get stricter and stricter every year.

also, it is upto the pharmacists judgment to fill a prescription or not depening on how legit the prescription looks. it is not illegal to refuse a prescription if we are not comfortable filling it. i have a life too and i have a family that i want to protect. i will not go to jail for some iffy prescription i dont feel comfortable feeling. it is true that pharmacists should provide other options to have the prescription filled, but honestly if i think its not legit, its ethically wrong for me to recommend another pharmacy/pharmacist to fill it.

and about being told to be too old and requiring diagnosis code. thats not us. that is 100% insurance. we dont have time, working at cvs (overworking us like dogs and slaves.. seriously bring so understaffed and having millions calls to make per day) we dont even have time to make up bs stories like that. while it could be that some pharmacists did not communicate tje information well enough… we dont purposely not give you the meds. we want to help you and make sure you get the right meds. and why would we want to create extra work by creating a false story only to get you mad and purposely not gove you the med. that doesnt make any sense! we want to get the prescription, fill it and get you going on your way. the biggest battle of our day is fighting with the insurance companies to get your meds covered. or call your doc to change it to something thats covered. insurance is the most complicated thing ever. every plan has a formulary (list of meds they cover) and they can change that list anhtime and make new rules and not even tell you about it. and next thing you know, you think its us thay changed the rules. no guys… we dont have ANY SAY in whats covered and not. thats your insurance company telling us what they want via their computer system to ours. and we are just the messengers informing you what they are saying. and everybody just wants to atrack the messenger. well, thats not gna fix the problem so think again!

and usually if the insurance doesnt cover something, we have no power to have that fixed. only your doctor can call the insurance and give them a diagnosis code (reason why you are takkng this med) to see if insurance will even budge. most of the time, we just wait on your doctor or your insurance. we are just the messengers. we tell them whats going on but we cant really do anything but wait. and most of the time, doctors office take forever to get back to us. the way cvs overworks the pharmacy team, we just cannot find the time to follow up on hundreds of patient’s problems like every hour. this is why, as a patient for your health, you need to participate and call the doctors office too!

and tell you the truth, there are millions of insurance plans out there and they all have different formularies (list of drugs they cover) and there is no way doctors office or the pharmacy know what your insurance covers. especially when each of those insurance plans decide to change their rules and formularies whenever they want.

thats healthcare for you in america. blame the system, we all just follow the rules.

@Cindy. No he wasn’t trying to do the right thing. The RIGHT thing would have been to have taken any of the steps outlined above, such as pull up her profile online or call her doctor.He opted instead to play rhe role of a judgemental ass, embarrassing and stereotyping this woman in front of a large group of people. What he did,in fact, was the opposite of the “right thing”

…also Cindy, by labeling her as “one of the few” who uses her medication responsibly you become just as judgemental as the pharmacist himself. …it is the minority of people who abuse prescription drugs, a sizable minority to be sure, but a minority nonetheless. .It is statements like this, with a pure disregard for the facts, that allows our national ignorance towards medications of all kinds to continue , making it even harder for the people who legitimately need them to get them

This is a question for any pharmacist who may be reading….So what happens when a person is prescribed stimulants for a diagnosis of narcolepsy? Or what if they are prescribed ritalin for dyslexia? Will pharmacists still refuse to fill the prescription? I don’t understand why the DEA isn’t going after the DOCTORS that prescribe controlled medications illegally. I understand why pharmacists would be wary of filling these type of medications, but if they abide by protocol, then pharmacists should be legally “ok.” However, not filling prescriptions due to paranoia and (most likely) due to discrimination and prejudice may lead to severe negative outcomes. In order to further my point, I’ll use anti-depressants as an example. If a severely depressed patient is prescribed anti-depressants and suddenly stops taking the medication, the likelihood that the patient will experience an increase in suicidal thoughts increases sharply; the likelihood that the same patient will act on those thoughts increases exponentially. Refusing to fill an anti-depressant medication may lead to suicide. Will the pharmacist be blamed then? I believe medical “professionals” should leave their “morals,” “ethics,” and opinions out of medical care. Pharmacists are supposed to receive a prescription, fill it, provide information about taking the medication, discuss any possible contra-indications, and give the medication to the patient. If the pharmacist is concerned about the medical diagnostic criteria that led to the diagnosis the patient carries, then the pharmacist should have gone to medical school to become a doctor that treats PEOPLE. I feel horribly for those people who have been made to feel shame, humiliation, and discrimination by pharmacists with god-complexes/pathological personalities. If pharmacists keep up the behavior that they are engaging in currently, it won’t be too long before the public will demand computerized machines that dispense medications with more efficiency to the consumer. How hard would it be to have a prescription with a barcode on it and insert it into a mechanized-dispenser in a pharmacy, and have the machine dispense a bottle of your medications like a vending machine? Pharmacists, keep your egos in check. If machines can replace people and make cars, I definitely believe machines can dispense medications and save consumers from experiencing hidden racism/prejudice/aggression. No one should feel ashamed or marginalized when receiving medical care.

Unfortunately unlike our parents’ /grrandparents’ world the Biases we experience are many times a lot more complex even though they stem from the same source ignorance. So sorry that happened to you and what he did was definitely wrong and probably he’ll be repremanded (maybe even moved to a new store) .. given the level of education needed I doubt they’ll simply fire him… Although I could be completely off. At the very least he should be able to wtrite you a personal letter of apology. People forced to take meds for any reason out of their control have a hard enough time. Like we want to be dependent on these medications (Epilepsy, Depression, ADD, etc.) for any length of time. But then to be made to feel ashamed of it by another human being, that’s just plain wrong. Many of those meds used for ADD also have a cross-use with people who have depression and PTSD…and this guy doesn’t know you or your medical history at all. Someone needs to remind him of his Hypocratic oathe to do no harm, I’m sure pharmacists who receive Doctorates also go through it.

I had surgery last October. I went to fill the medication that I was given for the pain. I went to the same CVS I have been going to for three years. The pharmacist refused to fill it because I looked high. First he said he didn’t have it, then called to another CVS. I was told that the other location had it, but not fill it for me. I was not going to drive back across the county. As I was walking away I heard him tell the technician, that he was not going to aid in someone’s addiction, she is high right now. I turned around when he said this and told him that when you have surgery you are given pain medications, and they don’t always wear off before you leave the hospital, and that I was not high I was tired.
Four days later I went in and filled the same prescription for my husband, no questions. Same technician, different pharmacist. The pharmacist apologized for his colleagues behavior.

Last week I went to my local CVS, the one I’ve gone to for nine years to fill my family’s scripts including my son’s ADHD meds. My pharmacist told me that they did not have any the medication on stock and handed the script back to me. I asked when they would have it in. He answered that he did not know. In shock, I replied that I needed these meds for my son. I asked if he would check other CVS pharmacies. He said he was not allowed to do that. There was an awkward silence and I asked him what I should do. He replied maybe I should drive around town looking for a pharmacy that would fill it. He suggested that maybe I should have my son’s doctor change his medicine to something else! After getting over that shock, I reminded him that I had been a loyal customer of this CVS branch for nine years. That I relied on this CVS to fill my family’s meds and that I was now feeling let down and insulted. His reply was a shrug.

I just was refused my prescription from CVS at the same Truckee, Ca pharmacy I used last year for all the same prescriptions. I travel every year between San Diego and Truckee, CA. I use the same pharmacy in both towns, the pharmacist has a reputation as an ass but still I’d never been refused my medications. He not only refused to fill it saying it was CVS policy but he walked away from me and wouldn’t ring me up for my other medications. This pharmacist has taken power to another level. It’s really too bad that a class action suit isn’t being filed against CVS, not only are they denying our meds they are passing judgement over us.

i see this is an older thread but wanted to add my experience to show that they are still having issues.

I went to CVS here in tampa fla to get my 9 year old sons script filled for his ADD. he has been on this for a while and has had it filled at this location many times. back in Nov 2014 i was told that they could not fill it with the generic even tho the script said it could be. the reason was it had the brand name Concerta on it. the script has been written the same and has never been changed. i was told it was against the law. i contacted CVS corporate offices and they got in touch with the area Mgr of the pharmacy and got it fixed and told me that the girl at the counter was wrong. Fat forward to yesterday May 21 2015.

The Dr raised the dosage of his meds and gave us a new script. back in Dec 2015 we got a pre auth from the Insurance company to get the brand because we determined that some of the generic cause illness with my son. just so you know pharmacies get the generics from many distributors and they are not al the same except for the active ingredient. i presented the new script to the girl at the drop off window and explained that we prefer the brand and that we have a pre auth with our insurance. she looked at the script and said that they can’t fill it for the brand because it does not state medically necessary. i asked why and she stated that it is against the law. i advised here that i am familiar with the fla statute 465.025 and that she is mistaken. i pulled it up on my device from the fla senates web page and showed here this.

465.025 Substitution of drugs.—
(1) As used in this section:
(a) “Brand name” means the registered trademark name given to a drug product by its manufacturer, labeler, or distributor.
(b) “Generically equivalent drug product” means a drug product with the same active ingredient, finished dosage form, and strength.
(c) “Prescriber” means any practitioner licensed to prescribe medicinal drugs.
(2) A pharmacist who receives a prescription for a brand name drug shall, unless requested otherwise by the purchaser, substitute a less expensive, generically equivalent drug product that is:
(a) Distributed by a business entity doing business, and subject to suit and service of legal process, in the United States; and
(b) Listed in the formulary of generic and brand name drug products as provided in subsection (5) for the brand name drug prescribed,
unless the prescriber writes the words “MEDICALLY NECESSARY,” in her or his own handwriting, on the face of a written prescription; unless, in the case of an oral prescription, the prescriber expressly indicates to the pharmacist that the brand name drug prescribed is medically necessary; or unless, in the case of a prescription that is electronically generated and transmitted, the prescriber makes an overt act when transmitting the prescription to indicate that the brand name drug prescribed is medically necessary. When done in conjunction with the electronic transmission of the prescription, the prescriber’s overt act indicates to the pharmacist that the brand name drug prescribed is medically necessary.

which was provided to me when we had the last issue in Nov. it clearly states that under section 2 that the only time they are not allowed to substitute a generic is, unless requested by the purchaser (Me) “or” the Dr writes Medically necessary. They still stuck to what she had said. the pharmacist explained to her how to put it thru and she continued to argue and picked up the phone and yelled over the intercom ” i need a manager to the pharmacy right now to deal with this unruly customer”.

The “Manager on duty” came and ask what the problem was and i began to explain and he interrupted and said i don’t need to hear from you i need to hear her. she explained her wrong version and then i explained the correct version. he said that he will not allow my script to be filled. i asked if he or her were licensed pharmacists, and they both said no. i explained that the pharmacist told her what to do and she refused stating it was illegal. i explained that neither one of them were a licensed pharmacist and therefore did not have the legal right to refuse ti fill the script. he turned to the pharmacist and asked him and he said ” i don’t want to get involved in this now”. the manager turn and said there you have it. i explained that he did not refuse to fill that he does not want to be a part of what you and your counter girl have started. and the pharmacist said thats correct.

The girl pulled up my history and said he has never gotten the brand we have always given the generic. i said what!!!? are you telling me that since Dec 2014 when we got the pre auth every time i have come in and requested brand you have filled it with generic. i said that is against the law you are required under them statue that you must notify that you filled it with a generic. so you filled it and left me thinking it was brand and it was not. and lied to me. i advised that i would contact the corporate office in regards to this and file a complaint with the state and walked away. as i was leaving the manager said “he sounds like he has a problem and just trying to get some pills”. i turned around and let him know that i hears what he said and would include that in my complaint and that if he really thinks that is the issue to call the local authorities and report me and give another reason to sue them.

How can these companies get away with acting this way and treating people like this. it is just horrible.

People that have a legitimate need for pain medicine are now called addicts and are harassed constantly due to the stigma that has been created about opiate pain medications. It is common business practice where I live to harass a person with a legitimate need for pain medicine until they become upset or angry, and then call the person a criminal or mentally ill. In fact, there is a huge incentive for doctors to misdiagnose or fail to diagnose an injured or sick patient and come off as one of the good guys by calling the patient a drug seeker or an addict. It is sickening to watch doctors profit from the pain and misery of their patients, with the only goal to chastise the patient for wanting legitimate relief from pain. I think the laws are creating problems for patients with legitimate pain as well, so that is another aspect of the problem that should be considered.

I have had chronic, severe pain from Fibromyalgia for 10 years. Once diagnosed and when I started to get prescriptions to help ease the multiple symptoms of this insidious condition, I’ve gone to CVS to have them filled. For the past 5 years I have been taking oxycontin for long-term pain relief and oxycodone for breakthrough pain so I have a history at CVS. These drugs do what they were made to do…ease my severe pain. I do not get high or have any side effects from these drugs. Anyway, I have been unable to get my prescriptions filled at local CVS pharmacies for at least 6x in the past 9 months. I’m being told it’s because they don’t have the supply needed to fill them. This past Friday I went to 10 CVS pharmacies in my area to fill my legal prescription. Not one CVS could fill it. I called my local CVS pharmacist and she wasn’t concerned at all. She said that I still had oxycodone and that I shouldn’t be affected and that I shouldn’t have side effects. What!!??? Of course I would have withdrawal symptoms if I fail to take the medication as prescribed. And I did. And because I upped my oxycodone dosage to handle some of the severe pain that would have been handled by the oxycontin, I will be short of oxycodone pills before my next prescription is written. This has happened to me too many times. On top of it, because it was a holiday weekend, I had to cancel my vacation plans because I knew my pain wouldn’t have been handled and I would be going thru withdrawal. CVS has caused me both physical and mental anquish for up to a week’s time until I was able to get it filled time and time again. It’s not fair. I feel like I’m being discriminated against because I have chronic physical pain.

I had to abruptly leave the country due to a family medical emergency. I made arrangements with my doctor and insurance via Skype and asked my husband to come help me. He was refused the 4 day early pick up of clonazepan. I have now been off it for 6 days and haven’t slept. Apparently, it is very dangerous to stop taking this suddenly when the body has depended on it for so long. I am so happy that CVS pharmacies have more knowledge than my prescribing doctor.

I get so sick and tired of pharmacist looking at me like a drug junkie. And that’s exactly what they do. I suffer from COPD and am on all kinds of meds. Until you have walked in someone else’s shoes don’t criticize.